Transitory Migratory Pulmonary Infiltrations Associated With Eosinophilia (Loeffler's Syndrome): With the Report of an Additional Case

Abstract

Since Loeffler's syndrome was first described in 1932, a large number of cases have been reported in the foreign literature and a small number in the English-American literature. Whether all of the reported cases are true instances of the syndrome is open to decided doubt. The syndrome is best described as a transitory, migratory pulmonary infiltration, demonstrable by roentgenologic examination and associated with eosinophilia, which may be very marked. The severity of the roentgenologic findings is in surprising contrast to the physical examination, which is frequently entirely negative, and to the minor symptomatology and mild clinical course. The pathogenesis is still undetermined, but the disease is now generally believed to develop on an allergic background, and intestinal parasitism has been identified as the causative agent in the few cases in which any identification at all has been possible. Diagnosis rests upon the radiologic picture, the transience of the roentgenologic findings, and the degree of eosinophilia. It cannot be made upon a single film. Pulmonary tuberculosis is the most frequent differential diagnostic consideration, and for therapeutic reasons the differentiation is extremely important. Therapy is directed toward the allergic disease, Loeffler's syndrome, in itself seldom requiring treatment. An additional case of Loeffler's syndrome is herewith added to the American literature of the subject.